Asian Nurs Res.
2016 Dec;10(4):283-288. 10.1016/j.anr.2016.09.003.
Nurse Staffing and 30-day Readmission of Chronic Obstructive Pulmonary Disease Patients: A 10-year Retrospective Study of Patient Hospitalization
- Affiliations
-
- 1Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea.
- 2Institute of Health Services Research, Yonsei University, Seoul, South Korea. thkim@yuhs.ac
- 3Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
- 4Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, South Korea.
- 5Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul, South Korea.
- KMID: 2374326
- DOI: http://doi.org/10.1016/j.anr.2016.09.003
Abstract
- PURPOSE
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity in many countries, and it has high rate of hospital readmissions due to recurrent exacerbations of the disease. Many previous studies have suggested further examination of the factors that contribute to hospital readmissions of COPD patients. However, evidence on the effects of nurse staffing by registered nurses (RNs) on the readmission of COPD patients is lacking in Korea. The aim of our study was to evaluate the effects of nurse staffing on hospital readmissions of COPD patients.
METHODS
We used National Health Insurance claim data from 2002 to 2012. A total of 1,070 hospitals and 339,379 hospitalization cases were included in the analysis. We divided the number of RNs per 100 beds and the proportion of RNs on staff to one of three groups (Q1: low; Q2: moderate; Q3: high). A generalized estimating equation model was used to evaluate the associations between readmission and nurse staffing.
RESULTS
A higher number of RNs was associated with lower readmission rates of 8.9% (Q2) and 7.9% (Q3) respectively. A similar effect was observed as the proportion of RNs among the total nursing staff gradually increased, resulting in lower readmission rates of 7.7% (Q2) and 8.3% (Q3).
CONCLUSIONS
Our results suggest notable positive effects of nurse staffing by RNs on patient outcomes. In addition, the magnitude of impact differed between different sizes of hospitals. Thus, human resource planning to solve staffing shortages should carefully consider the qualitative aspects of the nursing staff composition.
MeSH Terms
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Aged
Female
Health Facility Size/statistics & numerical data
Hospitals, General/statistics & numerical data
Humans
Male
Nurses/*supply & distribution
Nursing Staff, Hospital/*supply & distribution
Patient Outcome Assessment
Patient Readmission/*statistics & numerical data
Personnel Staffing and Scheduling
Pulmonary Disease, Chronic Obstructive/*nursing
Quality of Health Care
Recurrence
Republic of Korea
Retrospective Studies
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